About UHG

Careers at UnitedHealth Group


We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:

Medical and Clinical Operations



Postal Code:


Approximate Salary:

Not Specified

Position Type:

Full Time

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Health Care Complaints Specialist - Office-Based in San Francisco, CA

UHG - San Francisco, California

Posted: 10/28/2018

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)
Positions in this function are responsible for providing expertise or general support in reviewing, researching, investigating, negotiating and resolving all types of complaints and grievances. Communicates with appropriate parties on issues, implications and decisions.  Analyzes and identifies trends for complaints and grievances.   

This is an office-based position and will be working onsite in our San Francisco office.  Shift is Monday - Friday during normal business hours (8am-5pm PST).
Primary Responsibilities:
  • Providing expertise or general support in reviewing, researching, investigating, negotiating and resolving all types of complaints / grievances
  • Coordinating efforts with other areas as necessary
  • Communicating issues, implications and decisions with appropriate parties
  • Analyzing and identifying trends for complaints / grievances
  • Ensuring optimal performance re: timely, accurate, effective and complete responses
  • Verifying that all documentation, letters and attachments meet customer, regulatory and internal requirements
  • Preparing for and participating in audits
  • Organizing, checking, pulling, reviewing and saving files
  • Maintaining positive working relationships with internal and external customers including regulators
  • Other duties as assigned

Required Qualifications:     
  • Bachelor's Degree or equivalent experience
  • 2+ years of Managed Care experience
  • Excellent written communication skills
  • Word & Excel proficiency
  • Ability to prioritize and handle multiple tasks
  • Ability to successfully handle multiple projects and deadlines
  • Must be available and able to work out of our office in San Francisco, CA (425 Market Street, San Francisco, CA)
Preferred Qualifications:      
  • Previous Appeals and/or Complaints/Grievances experience
  • Previous behavioral health experience 
  • Previous claims experience
  • Bachelor's Degree in Healthcare, Behavioral Health, Business, Psychology or English
  • Must be proficient in developing accurate, easy to understand and thorough correspondence
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Key Words:  Appeals, Complaints, Grievances, Health Care, Managed Care, MCO, Behavioral Health, San Francisco, California, CA

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